Study Shows Alternative Tests Effective in Monitoring AIDS Progression In Patients; Underdeveloped Countries Could Benefit From Findings

INDIANAPOLIS-- Underdeveloped countries, in which 80 to 90 percent of the world's HIV- infected patients reside, should identify less costly ways to monitor the immune status of HIV-positive patients according to researchers at Indiana University School of Medicine, Indiana University School of Dentistry, the University of Panama and Social Security Hospital in Panama. Their study appears in this month's issue of Clinical and Diagnostic Laboratory Immunology.

The study evaluated the effectiveness of alternative immunological tests in monitoring the progression of AIDS. The most common test used to evaluate disease progression is the CD4 lymphocyte count. Researchers found that serum levels of Beta2- microglobulin, total serum IgA and total lymphocyte counts can also be used as predictors of disease progression because of their independent predictive values. The study showed the best predictive value, excluding the CD4 cell count, was obtained when total lymphocyte count and Beta2-microglobulin were analyzed together. Evaluation of p24 antigen levels were also included in the study, but found to be less predictive of disease progression.

According to Gerald McLaughlin, Ph.D., associate professor of pathology at the IU School of Medicine and part of the research team, the findings are significant because they suggest a less complicated and less expensive means of monitoring the disease progression in HIV-positive patients. This could be very beneficial for underdeveloped countries with large HIV-positive patient populations.

Currently, most patients in Panama (the patient population used for this study) who are HIV-positive are monitored every three months with a CD4 cell count test. The test is significantly more expensive ($50-$150) than the total lymphocyte count ($2-$6), serum Beta2-microglobulin ($8-$15) and total IgA ($8-$15) tests. These alternative blood tests are also easier to perform and produce results quicker. The Beta2-microglobulin and IgA can be performed without electricity.

McLaughlin noted that since the CD4 cell count is generally only performed every three months, there is the possibility that patients' disease can progress rapidly during the quarterly interval. The alternative tests could potentially be performed more often, allowing physicians to follow the AIDS disease progression more closely.

Although this study shows the alternative tests to be effective monitoring tools, further evaluation is needed before definite recommendations can be made about the reliability of the tests. If additional studies confirm the data, the findings could impact the care given to all HIV-positive patients in both underdeveloped and developed countries.

INDIANA UNIVERSITY
SCHOOL OF MEDICINE

MEDIA
RELATIONS

A STATEWIDE
RESOURCE

Phone
317 274 7722

Fax
317 278 8722